Autism Spectrum Disorder
Autism Spectrum Disorder (ASD) is a neuro-developmental disability that affects one’s ability to communicate and socially interact. ASD is often referred to as the ‘hidden’ disability as there is often nothing about how people look that sets them apart from others. People with ASD may however communicate, interact, behave and learn in ways which are different from most other people. People with ASD may have restricted or repetitive activities and interests and may also exhibit abnormal responses to sensory stimulation. Due to a lack of communication skills, it is not uncommon for those with ASD to exhibit problem behavior such as aggression and self-injurious behavior.
A diagnosis of ASD (according to the DSM-5) now includes several conditions, which used to be separately Autistic Disorder, Pervasive Development Disorder not otherwise specified, and Asperger syndrome. These conditions are all included in the diagnosis of Autism Spectrum Disorder.
ASD is usually diagnosed by the age of 2-4 years. ASD occurs in all racial, ethnic, and socio economic groups but is five times more likely among boys than girls. ASD affects an estimated 1 in 68 children. If you are concerned about your child, it is important to contact your doctor to share your concerns. If your doctor shares your concerns you should ask for a referral to a specialist who can make a more in depth evaluation of your child including possible diagnosis.
Developments in the Field
ASD continues to be a very important public health concern and for this reason there is ongoing research into its causes. Understanding the factors that make a person more likely to develop ASD will help us learn more about the causes and, in turn, may help with finding a cure. Studies to date have looked at many possible causes for ASD including genetic influences, environment influences, and brain tissue formation during pregnancy. Attempts at understanding how alterations in brain structure, chemistry and/or genetic factors contribute to ASD may lead to greater gains in the understanding of what causes ASD. Currently no cause or cure has been identified. The only treatment that has been supported by substantial empirical research is treatment based on the methods of Applied Behavior Analysis.
Applied Behavior Analysis (ABA)
Applied Behavior Analysis (ABA) is the application of the principles of learning and motivation from Behavior Analysis to the solution of problems of social significance. ABA has been validated by decades of scientific research on treatments for children with Autism Spectrum Disorder (ASD). It is used to teach functional and relevant skills to give young children with ASD the tools they need to learn and succeed.
ABA treatment includes:
- increasing appropriate behaviors (e.g. using reinforcement procedures to increase on-task behavior or social interactions)
- teaching new skills (e.g., systematic instruction and reinforcement procedures teach functional life skills, communication skills, or social skills)
- maintaining behaviors (e.g., teaching self control and self-monitoring procedures to maintain and generalize social skills)
- generalizing behavior from one situation to another (e.g., from correctly completing tasks in session to being able to complete the same task in the natural environment)
- narrowing conditions under which interfering behaviors occur (e.g., self injury or stereotypy).
ABA therapy should begin as soon as the child has been diagnosed or as early as possible. Based on clinical observation and statistical research, ABA therapy is most effective when applied 20-40 hours per week. The treatment is individualized to reflect each child’s strengths and needs. Each child receives a comprehensive program of treatment in all skill domains including communication, academics, social skills, and adaptive living skills. Adaptive living skills include gross and fine motor skills, eating and food preparation, toileting, dressing, personal self-care, domestic skills, time and punctuality, money and value, home and community orientation, and work skills
The process of ABA Therapy
- selection of interfering behavior or behavioral skill deficit
- identification of goals and objectives
- establishment of a method of measuring target behaviors
- evaluation of the current levels of performance (baseline)
- design and implementation of the interventions that teach new skills and/or
- reduce interfering behaviors
- continuous measurement of target behaviors to determine the effectiveness of the intervention, and ongoing evaluation with modifications made as necessary to maintain and/or increase both the effectiveness and the efficiency of the intervention.
Treatment approaches grounded in ABA are now considered to be at the forefront of therapeutic and educational interventions for children with ASD. The large amount of scientific evidence supporting ABA treatments for children with ASD have led a number of other independent bodies to endorse the effectiveness of ABA, including the U.S. Surgeon General, the New York State Department of Health, the National Academy of Sciences, and the American Academy of Pediatrics.